Abstract
Abstract Aim Necrotising Fasciitis (NF) is a rapidly progressing soft tissue infection that necessitates prompt diagnosis and management. This study examined NF cases over a 5-year period at Bradford Royal Infirmary and those referred from local hospitals to enhance patient care and outcomes. Method Cases coded as “Necrotising Fasciitis” between April 2018 and January 2023 were retrospectively reviewed using electronic records. These encompassed patients transferred for plastic surgery input and those admitted under various specialties. Data on risk factors, admission details, surgical interventions, microbiology results, and outcomes were collected. Microbiology results included histology, tissue, swabs and blood cultures if sent. Results A total of 50 cases were identified - 33 male and 17 female patients with a mean age of 53 (range of 25-93). The mean Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC) score was 8.6 prior to debridement. Of the 13 cases with histological confirmation, 2 were calculated as low risk and 2 as intermediate. Tissue cultures showed 21 cases with E. Coli and/or Mixed Anaerobes (Type 1) and 8 with Group A Strep and/or Staph Aureus (Type 2). 4 cases did not require debridement, while others needed an average of 2.3 debridements. 23 of the 45 patients required reconstruction by the local plastics team. 37 patients of the total 50 were discharged, 3 self-discharged and 10 died acutely (22.2% mortality rate). Conclusions While the LRINEC score is a valuable indicator for NF, histology demonstrates its limitations. It is an adjunct, not a substitute, to clinical diagnosis, ensuring accurate management and preventing misdiagnosis.
Published Version
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